Does acute soccer heading cause an increase in plasma S100B? A randomized controlled trial

Abstract

The purpose of this study was to test the effect of subconcussive head impacts on acute changes in plasma S100B. In this randomized controlled trial, 79 healthy adult soccer players were randomly assigned to either the heading (n = 41) or kicking-control groups (n = 38). The heading group executed 10 headers with soccer balls projected at a speed of 25 mph, whereas the kicking-control group performed 10 kicks. Plasma samples were obtained at pre-, 0h post-, 2h post- and 24h post-intervention and measured for S100B. The primary hypothesis was that there would be a significant group difference (group-by-time interaction) in plasma S100B at 2h post-intervention. Secondary hypotheses included (1) no significant group differences in plasma S100B concentrations at 0h post- and 24h post-intervention; (2) a significant within-group increase in S100B concentrations in the heading group at 2h post-intervention compared to pre-intervention; and (3) no significant within-group changes in plasma S100B in the kicking-control group. Data from 68 subjects were available for analysis (heading n = 37, kicking n = 31). There were no differences in S100B concentrations between heading and kicking groups over time, as evidenced by nonsignificant group-by-time interaction at 2h post-intervention (B = 2.20, 95%CI [-22.22, 26.63], p = 0.86) and at all the other time points (0h post: B = -11.05, 95%CI [-35.37, 13.28], p = 0.38; 24h post: B = 16.11, 95%CI [-8.29, 40.51], p = 0.20). Part of the secondary outcome, the heading group showed elevation in plasma S100B concentrations at 24h post-intervention compared to pre-heading baseline (B = 19.57, 95%CI [3.13, 36.02], p = 0.02), whereas all other within-group comparisons in both remained nonsignificant. The data suggest that 10 bouts of acute controlled soccer headings do not elevate S100B concentrations up to 24-hour post-heading. Further dose-response studies with longer follow-up time points may help determine thresholds of acute soccer heading exposure that are related to astrocyte activation. The protocol was registered under ClinicalTrials.gov ( NCT03488381 ; retrospectively registered.).

A Kinetic Model for Blood Biomarker Levels After Mild Traumatic Brain Injury

“…Blood biomarkers have been investigated as predictors of neuroimaging abnormalities (abnormal CT and MRI scans) (9,20,(35)(36)(37)(38). Blood biomarkers have uncertain value in predicting the late effects of TBI (39)(40)(41)(42), in detecting sub-concussive blows to the head (43)(44)(45)(46), and in predicting readiness for return to play (47). Questions remain as to the preferred time to measure blood biomarkers, the preferred and Tmax are mid-range estimates † S100B is eliminated by first order kinetics.…”

Salivary S100 calcium-binding protein beta (S100B) and neurofilament light (NfL) after acute exposure to repeated head impacts in collegiate water polo players

“…Playing time or other measures of exertional load (e.g., heart rate) may be helpful for teasing out these confounding effects and clarifying the source of salivary S100B in future studies 27 . We based our power simulations on the findings of Huibregtse et al, who likely used a kicking-control group as a means of controlling for this exertional confound 55 . However, the only 24-h effect those authored reported was elevated S100B within the soccer-heading group, not an interaction effect.…”

“…Post-tournament salivary NfL was simulated as an increase beyond baseline NfL of 0.066 pg/ml per head impact with a random additive error term of ± 0.022 pg/ml per head impact 36 . Post-tournament salivary S100B was simulated as an increase from baseline S100B of 1.95 pg/ml per head impact with a random additive error term of ± 1.6 pg/ml per head impact 55 .…”

The biological significance and clinical utility of emerging blood biomarkers for traumatic brain injury

“…Circulating levels of S100B have consistently been shown to increase in an impact-dependent manner in field studies of American football players and soccer players (Kawata et al, 2017;Marchi et al, 2013;Stalnacke et al, 2004;Zonner et al, 2019). However, using a laboratory model of subconcussive head impacts, performing 10 controlled soccer headers was not a sufficient stimulus to trigger an increase in plasma S100B relative to a control group (Huibregtse et al, 2020). In the absence of a clinically diagnosed TBI, physical exertion is similarly a confounding factor when using peripheral levels of S100B to ascertain damage due to repetitive head impact exposure (Rogatzki et al, 2018;Straume Naesheim et al, 2008).…”